Chris Moulton @DrChrisMoulton
National Clinical Lead for GIRFT for Emergency Medicine; erstwhile Consultant in EM at the Royal Bolton Hospital and VP of RCEM rcem.ac.uk Bolton, England Joined February 2016-
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@RCollEM The new pathway should mandate fewer scans than the preceding SBNS/BASS guideline (attached) as bilateral sciatica is no longer an indication for emergency MRI. The pathway was accompanied by a @RCRadiologists document on extending OOH MRI provision: shorturl.at/pwyI9
This is what is needed and what doctors thought we were getting with PAs ⬇️
4⃣0⃣0⃣ NHS colleagues are now logging in to our SEDIT data tool every month… are you? The SEDIT is our online repository of EM data, helping you evaluate your ED’s current demand, capacity, flow & outcomes, and target the cause of any issues Get started▶️ gettingitrightfirsttime.co.uk/sedit/
We must make sure that mental health is always included in the list of specialties that provide SDEC and “hot” clinic spaces. This will help to reduce the very long waits in EDs for patients with mental health problems. @NHSGIRFT @RCollEM
This is exactly why GIRFT for UEC calls general and acute beds a “dominant constraint” that makes good ED patient flow very difficult to achieve, if there are too few beds for the admission load of the hospital. @NHSGIRFT @RCollEM @NHSEngland @NHSProviders @NHSBenchmarking
This is exactly why GIRFT for UEC calls general and acute beds a “dominant constraint” that makes good ED patient flow very difficult to achieve, if there are too few beds for the admission load of the hospital. @NHSGIRFT @RCollEM @NHSEngland @NHSProviders @NHSBenchmarking
And I was very honoured to receive a signed copy, Kaushi. Thank you very much.
The six steps cover: 1⃣Protecting SDEC capacity and function 2⃣Best practice for ward rounds and handover 3⃣Pharmacy 4⃣Access to diagnostics 5⃣Workforce optimisation 6⃣Access to AHPs and acute frailty services 👉bit.ly/3QDYIM6 2/2
NEW! We’ve pinpointed 6⃣ vital steps acute hospitals can take to help improve flow during the winter. Read and download our new ‘Six To Help Fix’ guidance w/ SAM (@acutemedicine) to see what you might be able to work on: 👉bit.ly/3QDYIM6 1/2
So very true, Adrian.
👏🌟🎖️Huge congratulations this morning to our radiology lead, Dr Giles Maskell, on being made an OBE. We can’t think of anyone more deserving of the honour, awarded for services to diagnostic radiology. Enjoy your celebrations, Giles! #KingsBirthdayHonours @RCRadiologists
4⃣0⃣0⃣ registrations for our SEDIT webinar! An online depository of emergency medicine data, the SEDIT supports systems and trusts to understand the complex dynamic between demand, capacity, flow and outcomes. Register below 🔗bit.ly/42ybqyT
🆕 #GIRFT WEBINAR 'Getting started with the Summary Emergency Department Indicator Table (#SEDIT)' 🗓️ 24/05 ⌚️ 12:30 - 13:30 Join @DrChrisMoulton and #ED colleagues for this informative, data-driven session. Register below: 🔗bit.ly/42ybqyT
I was particularly struck by discussions around internal demand ie demand created by organisations due to poor processes or poor IT to name a couple. What could we do to minimise this? It would surely be a boost to our workforce and improve patient care. #tacklingharmtogether
Alternatives to ED (A-tED) / Alternatives to Admission (A-tA) offer a robust scoring system to support systems and trusts manage demand across emergency departments and urgent care services. Find out more bit.ly/40sWn8G @DrChrisMoulton #emergencymedicine #ED #NHS
🆕 #GIRFT and the Urgent and Emergency Care (UEC) programme have developed a user-friendly improvement tool to support health and care systems with local #ED challenges: 🟥Alternatives to ED (A-tED) 🟥Alternatives to Admission (A-tA) 👇 bit.ly/40sWn8G @DrChrisMoulton
🔟days to go! 'The new GIRFT national pathway for patients with suspected cauda equina syndrome'. Register below: 🔗 bit.ly/3YlIUyF #CES
Thank you, Ned. That is great to hear. SEDIT version 5 is on its way and will have lots more improvements.
Thank you, Ned. That is great to hear. SEDIT version 5 is on its way and will have lots more improvements.
Adrian Boyle @RCEMpresident
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Self check-in and algorithm-led initial triage is helping @NHSHomerton Emergency Department to have some of the best access times in the NHS, not to mention a continuous flow mindset that sees no patient waiting to be handed-over or cared for in escalation areas. Just wow 🤩
The data starkly illustrates the reality for politicians about to write manifestos. There is a binary choice: significant investment with sustainable plans increasing capacity or presiding over a system that is permeated with degrading corridor care and unnecessary deaths.
Latest NHS stats...my analysis. We are at risk of obsessing over miniscule changes in what is otherwise a planet sized clusterfuck of poor performance that started long before Covid. Or in gif form...
A huge thank you to @RoyalFreeNHS for welcoming me to the launch of their Quality Strategy this morning. When quality is the strategy, productivity and innovation follow ⭐️
I try to avoid walking down our corridor or through our waiting room when not working clinically… it’s worse than embarrassment for me, I feel ashamed of how we are forced to treat our patients. We’ve normalised so much.
If I'm completely honest: I'm too embarrassed to make eye contact with patients bedded in our A&E corridors, or waiting in the ambulance offload queue. I suspect so does hospital executive teams, who rarely come to A&E, and when they do, rarely engage with patients.
@RCollEM The new pathway should mandate fewer scans than the preceding SBNS/BASS guideline (attached) as bilateral sciatica is no longer an indication for emergency MRI. The pathway was accompanied by a @RCRadiologists document on extending OOH MRI provision: shorturl.at/pwyI9
@RCollEM If the DGH doesn’t have out of hours MRI, then discuss with the tertiary centre who do. They will either transfer out of hours for the scan or advise to wait and have local scan when MRI is available. This guidance is excellent at stopping the merry go round of patient referrals
This is what is needed and what doctors thought we were getting with PAs ⬇️
Let us introduce our Acute Assessment Units Doctors' Assistants! They are always super busy on the ward doing bloods/cannulas/ECGs & chasing things. They also draft discharge letters ready for our medical team to approve & prescribe on! #NHS #MedTwitter #AcuteCare #MYTeam
Anne Frank photographed with her sister Margot at the beach in Zandvoort, Netherlands, in 1940. Margot was the elder sister of Anne, and according to Anne’s diary, she also had kept a diary of her own, but no trace of it has ever been found. She died in the…
Derek Thompson: Casualty's Charlie Fairhead to leave after 38 Few people last as long in Emergency Medicine as Charlie. Thank you! bbc.co.uk/news/entertain…
This response to Channel 4's depressing summary of NHS performance suggest that NHSE stands for NHS Excuses. It typifies their strategy of basically denying reality...
So shocked @BootsUK that your Poole branch no longer has cashiers. Your new self service check out was causing a lot of people distress today as they found the technology difficult to cope with. Human interaction so important, especially in a shop like yours
This year is the 100th anniversary of the first Labour Prime Minister. Nobody is celebrating as Ramsay MacDonald as he became a non-person in Labour history. But history is worth remembering...
Here is a puzzle for health simulation modellers: how does a paper trying to model time spent in the ED validate its model when it claims not to have access to departure time data about the real world ED the model is based on? (see the limitations section)
#Jan2024 #OriginalResearch What impact would reducing low-acuity attendance have on emergency department length of stay? A discrete event simulation modelling study. @SCHARRSheffield emj.bmj.com/content/41/1/27
Over 400 people have registered so far – but its not too late. ⌛️ This webinar will demonstrate how our new pathway can support surgical colleagues to care for people with diabetes. TOMORROW at 1.00 pm 🔗 bit.ly/49hTmfZ
@mancunianmedic The posts completely missing your satire 😂😂😂😂😂😂😂
@pendlehilll i am a long-serving NHS doctor there was no need to break in But the satirical element might have evaded you, just like i evaded the door security
Three Teams calls into the first day of industrial action and the level of sheer hard work, grip and determination from everyone across the NHS is once again clear 🙏
4⃣0⃣0⃣ NHS colleagues are now logging in to our SEDIT data tool every month… are you? The SEDIT is our online repository of EM data, helping you evaluate your ED’s current demand, capacity, flow & outcomes, and target the cause of any issues Get started▶️ gettingitrightfirsttime.co.uk/sedit/
A huge thank you to the team @ImperialNHS for making me so welcome yesterday. It was a stark reminder that not all SDECs are created equal, and that patient focused ‘floor rounds’ can transform lives as well as flow. I haven’t smiled that much at work in a long time 💙